Impact of Birthing Practices on Breastfeeding, Second Edition examines the research and evidence connecting birth practices to breastfeeding outcomes. It takes an in-depth look at the post-birth experiences of the mother and baby, using the baby’s ability to breastfeed as the vehicle, the mother’s lactation capacity as a factor, and the intact mother-baby dyad as the model to address birth practices that affect breastfeeding.

The Second Edition has been completely revised to include new information on infant outcomes, including epidural anesthesia and Cesarean surgery, clinical strategies for helping the mother and baby recover from birth injuries, medications and complications, and information on the World Health Organization’s Baby-Friendly Hospital Initiative™ with its Mother-Friendly Childbirth Module.

New Chapters Include:

Companion(s) of the Mother’s Choice

Cascade of Interventions: Chance or Choice? The “Seduction of Induction”

Linda J. Smith, MPH, IBCLC, FACCE, FILCA is currently Adjunct Instructor in the Center for Global Health, Department of Community Health, Boonshoft School of Medicine at Wright State University. She is also the Owner/Director of Bright Future Lactation Resource Centre in Dayton, OH. Linda’s 40-year career in women's health advocacy and support began as a physical education teacher and extends into her practice as lactation consultant, childbirth educator, and public speaker. She is the author of 4 professional textbooks on birth and breastfeeding and co-author of Sweet Sleep by La Leche League International. She has lectured in 19 countries; her presentations have been translated into 12 languages including Chinese, Russian and Inuktitut. She has presented her key research areas to international health experts at the World Health Organization meetings. Linda was a founder of IBLCE, founder and past board member of ILCA, and her Lactation Consultant Exam Preparation Course is the longest-running of its kind and the first to be based on the IBLCE Exam Blueprint.

Linda Smith obtained her MPH from Wright State University and her BSE from the State University of New York at Cortland in physical education. She is an International Board Certified Lactation Consultant (IBCLC), a Lamaze Certified Childbirth Educator (LCCE), and a La Leche League International Accredited Leader. She holds or has held leadership positions in the American Public Health Association (APHA), United States Breastfeeding Committee (USBC), the American Breastfeeding Institute (ABI), the International Lactation Consultant Association (ILCA), and the International Board of Lactation Consultant Examiners (IBLCE). Linda serves as ILCA’s liaison to the World Health Organization’s Baby Friendly Hospital Initiative and as a consultant to Baby-Friendly USA and INFACT Canada/IBFAN North America. She has been an expert reviewer on several documents published by the US Department of Health and Human Services and the Centers for Disease Control and Prevention.

Mary Kroeger has been a nurse-midwife for twenty-three years. In the United States, she has practiced full-scope midwifery in all settings: home, birth center and hospital. Her additional expertise in lactation management has been acquired through her midwifery practice, as a member of the clinical faculty at Wellstart International in San Diego and as senior technical staff with LINKAGES, a global breastfeeding promotion project based in Washington DC.

Mary’s activities and advocacy for a holistic model of maternity care spans many worlds. She maintains active membership in both the American College of Nurse-Midwives (ACNM) as well as the Midwives Association of North America (MANA) the latter whose constituency are largely homebirth-oriented care providers. She is the current Co-coordinator of the World Alliance of Breastfeeding Action (WABA) Health Care Practices Task Force and chairs the International Committee of the Coalition to Improve Maternity Services (CIMS).

Since 1983, Mary has lived and worked eight years overseas in Belize, Somalia, Swaziland, Kazakhstan, and Indonesia serving as a specialist in safe motherhood, child survival and breastfeeding. She has also consulted widely for global health organizations including UNICEF, WHO, World Bank, United States Agency for International Development and Save the Children/US. This work has taken her to over twenty countries on four continents and has found her frequently a counterpart with program planners, educators and policy makers in ministries of health, with international non-governmental organizations, and with traditional village midwife groups where she has tried to bridge the gap between developing country realities and western norms and standards that are inevitably introduced with development work. In the last five years, Kroeger’s work has increasingly included technical assistance to countries in the throes of the HIV/AIDS pandemic, providing guidance in reduction in transmission of HIV from mother-to-child during pregnancy, childbirth and infant feeding.

Mary is a mother of three grown children, one stepson, and a granddaughter. She and her husband, Robert, live in Takoma Park, Maryland.

Labor and delivery nurses take care of two patients - but one is invisible. Research too often seems invisible too - how many anesthesiologists read the lactation research? How many nurses read the anesthesia research? And who will speak for that invisible baby? Linda Smith has done a great job of gathering research from many disciplines, and her conclusions are startling. We need safe, healthy births from both maternal and infant perspectives. This new edition is both a call to arms and a compelling read.
- Dawn M. Kersula MA, RN, FACCE, IBCLC

Birth in our culture continues to see rising interventions without improvement in outcomes. Research shows us why. Increasingly, it connects medicalized birth with breastfeeding difficulties. But research moves fast these days. Happily, there’s Linda Smith to keep us abreast of the latest studies. Nobody knows the research on birth and breastfeeding better than Linda. And nobody’s done a better job of presenting it to professionals and mothers, making the link between birth and breastfeeding abundantly, abundantly clear.
- Diane Wiessinger, MS, IBCLC

Anytime you interfere with the natural flow of things, you’d better have a real compelling reason. Not an imagined reason. Not because of a clock. Not because you’re on a schedule. Not for convenience. Because during birth, you are most assuredly affecting, for life, the relationship of mother and baby.
-Anonymous

Whether you are a mom or a health care provider, this revised edition of Linda's Smith's ground-breaking book will explain in accessible language the newest research about the impact of birth practices on breastfeeding success. This is information you won't find anywhere else and now it's more complete than ever before. This second edition is one of the most valuable resources in my lactation practice because the birth process has such a fundamental affect on breastfeeding.- Diana West, BA, IBCLC
Co-Author of The Breastfeeding Mother's Guide to Making More Milk